Title |
Abatacept reduces synovial regulatory T-cell expression in patients with psoriatic arthritis
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Published in |
Arthritis Research & Therapy, July 2017
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DOI | 10.1186/s13075-017-1364-3 |
Pubmed ID | |
Authors |
Agnes Szentpetery, Eric Heffernan, Martina Gogarty, Lisa Mellerick, Janet McCormack, Muhammad Haroon, Musaab Elmamoun, Phil Gallagher, Genevieve Kelly, Aurelie Fabre, Brian Kirby, Oliver FitzGerald |
Abstract |
The aim was to study changes in immunohistochemical expression markers of synovial and skin inflammation, clinical outcomes and magnetic resonance imaging (MRI) scores with abatacept treatment in patients with psoriatic arthritis (PsA). Biological-treatment-naïve PsA patients with active disease including synovitis of a knee were enrolled in this single-centre, crossover study. Patients were randomised to receive intravenous abatacept 3 mg/kg of body weight or placebo infusion on day 1, 15 and 29; thereafter abatacept 10 mg/kg of body weight was administered every 28 days for 5 months. Clinical data were collected at each visit. Synovial biopsy of the involved knee was obtained at baseline and 2 and 6 months. MRI of the same knee and skin biopsy was performed prior to arthroscopy. Fifteen patients were recruited. Significant improvements in the joint-related measures were observed; 90% were European League Against Rheumatism criteria responders and 30% achieved psoriasis area severity index (PASI)50 at 6 months. Reduction in synovitis (P = 0.016) and vascularity (P = 0.039) macroscopic scores consistent with decrease in total MRI score (P = 0.016) were noticed. Abatacept decreased the immunohistological expression of FOXP3+ cells (P = 0.027), specifically the expression of CD4+FOXP3+ regulatory T cells (Tregs) (P = 0.008) in the synovium over 6 months. There was no significant clinical or immunohistological change in any of the skin measures. This is the first study assessing synovial and psoriatic skin immunpathological changes following abatacept treatment in PsA. Reduction in Treg expression in the synovium but not in the psoriatic lesion suggests abnormal Treg function in PsA with differential suppressive capacity in the synovium compared to the lesional skin. The results of this study demonstrate that abatacept 10 mg/kg of body weight might be an effective treatment option for joint disease in patients with PsA. Irish Health Products Regulatory Authority. CT 900/489/1 - Abatacept (case number: 2077284, EudraCT Number: 2009-017525-19, Protocol number: 77777). Registered on 12 March 2010. |
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Geographical breakdown
Country | Count | As % |
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Unknown | 2 | 100% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 2 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 80 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Researcher | 11 | 14% |
Student > Ph. D. Student | 9 | 11% |
Student > Bachelor | 8 | 10% |
Student > Postgraduate | 7 | 9% |
Student > Master | 7 | 9% |
Other | 16 | 20% |
Unknown | 22 | 28% |
Readers by discipline | Count | As % |
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Immunology and Microbiology | 4 | 5% |
Nursing and Health Professions | 3 | 4% |
Agricultural and Biological Sciences | 3 | 4% |
Biochemistry, Genetics and Molecular Biology | 3 | 4% |
Other | 14 | 18% |
Unknown | 24 | 30% |